The ORACLE I trial evaluated the use of antibiotics in women with preterm prelabour rupture of membranes (PPROM). Its principal finding regarding erythromycin was:

• A Erythromycin prolonged latency and improved neonatal outcomes without adverse effects
• B Co-amoxiclav was associated with increased risk of neonatal necrotizing enterocolitis ✓
• C Erythromycin and co-amoxiclav both improved neonatal outcomes equally
• D Erythromycin had no effect on latency but reduced chorioamnionitis

Explanation

The ORACLE I trial (Kenyon et al., 2001) showed that erythromycin significantly prolonged latency and reduced neonatal morbidity in PPROM. Co-amoxiclav (amoxicillin-clavulanate) was associated with a significant increase in neonatal necrotising enterocolitis — a critical safety finding. As a result, erythromycin alone (not co-amoxiclav) is the antibiotic of choice in PPROM. This remains a frequently tested named-trial fact.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.